Overview of the Risk Factors and the Application of Major Surgical Site Infections Preventive Strategies

Abstract

Introduction. Surgical site infections (SSIs) have been a clearly defined nosology since many decades, and despite all the efforts towards their prevention and control, they still account for the majority of burden within Healthcare Associated Infections (HAI). SSIs are clearly proved to increase both morbidity and mortality of the affected individuals, and their treatment is challenging and costly at the same time. Purpose. Following the literature review, our goal is to determine the main preventive strategies for SSI and risk factors, as well as to analyze the level of implementation of these strategies in our study center Trauma University Hospital in Tirana. Methodology. A literature review on the PubMed search engine for articles with the keywords "surgical wound infection" and "risk factors for surgical wound infection" revealed the main risk factors and four key preventive strategies for SSI in accordance with the World Health Organization (WHO) guidelines for the prevention of SSIs. Subsequently, we retrospectively analyzed the level of awareness and implementation of these four preventive strategies for SSI in the surveillance database of preventive measures for elective surgeries at the Trauma University Hospital in Tirana. Results. The top four policies most widely accepted internationally from almost all concerned entities are antibiotic prophylaxis, proper preparation of surgical field, normothermia and local hair removal. Our local institutional protocols and ongoing surveys are reassuring regarding implementation of only two of the above, the antibiotic prophylaxis and hair removal strategies. Conclusion. While the antibiotic prophylaxis and hair removal application strategies appear to satisfy our current expectations, the implementation of intraoperative normothermia and a standardized surgical site preparation are absent to deficient, and possible reasons might include insufficient knowledge distribution, and improper adherence with such knowledge.

Received: 19 January 2025 / Accepted: 18 March 2025 / Published: 25 March 2025